Reform Drumbeat Picks Up; Speaker Hastert Says He Hears It

February 1, 1999

President Clinton's impeachment trial has diverted attention from health care reform, which has been quietly thrust into high gear. Regarding Medicare, the administration proposed two ideas: cutting paymentsto hospitals and channeling 15 percent of budget surpluses to the Medicare trust fund. Some of the newfound money would cover prescription drugs.

The Health Insurance Association of America, American Association of Health Plans, and American Hospital Association decried the possibility of any cuts, but the president may have struck a chord with the public.

A Kaiser Family Foundation survey listed preservation of Medicare second to Social Security among voters' priorities for Congress this year; 59 percent support reducing provider payments to stabilize Medicare.

The same survey found 54 percent of voters wanting Congress to take up managed care reform — a fight already taking shape. House speaker Dennis Hastert, whose reputation is that of a consensus builder, promised that HMO reform will get a good airing on the House floor this year. Even so, Hastert's elevation to speaker has made HMOs and health insurers happy; almost one fifth of Hastert's 1998 campaign funding came from health and pharmaceutical concerns. What this means for the reform debate is not yet clear, but HIAA President Chip Kahn told the Washington Post he doesn't expect reform-minded lobbyists to get far with Hastert.